摘要
AIM: To investigate the incidence of CD117-positive immunohistochemical staining in previously diagnosed gastrointestinal (GI) tract stromal tumors (GTST) and to analyze the tumors' clinical manifestations and prognostic factors.METHODS: We retrospectively reviewed 91 cases with a previous diagnosis of GI stromal tumor, leiomyoma, or leiomyosarcoma. Tissue samples were assessed with CD117, CD34, SMA and S100 immunohistochemical staining. Clinical and pathological characteristics were analyzed for prognostic factors.RESULTS: CD117 was positive in 81 (89 %) of 91 tissue samples. There were 59 cases (72.8 %) positive for CD34,13 (16 %) positive for SMA, and 12 (14.8 %) positive for S100. There was no gender difference in patients with CD117-positive GIST. Their mean age was 65 years. There were 44 (54 %) tumors located in the stomach and 29 (36 %)in the small intestine. The most frequent presenting symptoms were abdominal pain and GI bleeding. The mean tumor size was 7.5±5.7 cm. There were 35 cases (43.2 %)with tumors ＞5 cm. The tumor size correlated significantly with tumor mitotic count and resectability. Tumor size, mitotic count, and resectability correlated significantly with tumor recurrence and survival. There was recurrent disease in 39 % of our patients, and their mean survival after recurrence was 16.6 months. Most recurrences were at the primary site or metastatic to the liver. Twenty-six percent of our patients died of their disease.CONCLUSION: Traditional histologic criteria are not specific enough to diagnose GIST. This diagnosis must be confirmed with CD117 immunohistochemical staining. Prognosis is dependent on tumor size, mitotic count, and resectability.
AIM:To investigate the incidence of CD117-positive immunohistochemical staining in previously diagnosed gastrointestinal(GI)tract stromal tumors(GIST)and to analyze the tumors' clinical manifestations and prognostic factors. METHODS:We retrospectively reviewed 91 cases with a previous diagnosis of GI stromal tumor,leiomyoma,or leiomyosarcoma.Tissue samples were assessed with CD117,CD34,SMA and S100 immunohistochemical staining.Clinical and pathological characteristics were analyzed for prognostic factors. RESULTS:CDl17 was positive in 81(89 %)of 91 tissue samples.There were 59 cases(72.8 %)positive for CD34, 13(16 %)positive for SMA,and 12(14.8 %)positive for S100.There was no gender difference in patients with CD117-positive GIST.Their mean age was 65 years.There were 44(54 %)tumors located in the stomach and 29(36 %) in the small intestine.The most frequent presenting symptoms were abdominal pain and GI bleeding.The mean tumor size was 7.5±5.7 cm.There were 35 cases(43.2 %) with tumors>5 cm.The tumor size correlated significantly with tumor mitotic count and resectability.Tumor size,mitotic count,and resectability correlated significantly with tumor recurrence and survival.There was recurrent disease in 39 % of our patients,and their mean survival after recurrence was 16.6 months.Most recurrences were at the primary site or metastatic to the liver.Twenty-six percent of our patients died of their disease.CONCLUSION: Traditional histologic criteria are not specific enough to diagnose GIST. This diagnosis must be confirmed with CD117 immunohistochemical staining. Prognosis is dependent on tumor size, mitotic count, and resectability.
